Case Of Idiopathic Hypoparathyroidism Research Articles

A case of idiopathic hypoparathyroidism in a teenager

A case of idiopathic hypoparathyroidism in a teenager

SUN-511 A Hard Headed Man: He’s Got Calcium on the Brain

Hypoparathyroidism, first described in 1912 by Collip has an estimated incidence of 24-37/100,000 person-years with the most common cause being anterior neck surgery. Other etiologies include infiltrate diseases like sarcoidosis, vitamin D deficiency, and heritable syndromes like autoimmune polyglandular syndrome type 1. Idiopathic hypoparathyroidism (IHPTH) is diagnosed when PTH and calcium levels are both low. The association between hypoparathyroidism and basal ganglia calcifications was first described in 1939 by Eaton. Commonly, patients with basal ganglia calcifications present with seizures. A case of IHPTH and basal ganglia calcification in a patient with a past medical history of epilepsy is described. A 33-year-old male with past medical history of epilepsy, depression, alcohol, and polysubstance abuse presented for suicidal ideations to LAC-USC ER. He reported perioral numbness and numbness and tingling in his hands and feet bilaterally. He was taking valproic acid for his seizures, but ran out. Physical exam was significant only for a positive Trousseau’s sign. CMP showed a calcium of 5.8mg/dL (n: 8.5-10.3), albumin of 3.8 g/dL, and phosphorus of 5.9mg/dL (n: 2.5-4.5). The differential diagnosis for hypocalcemia included magnesium deficiency from alcohol abuse, vitamin D deficiency, or pseudohypoparathyroidism. Additional labs showed PTH of 6 pg/mL (n: 15-65), magnesium of 1.9 mg/dL, and vitamin D 25 of 31ng/ml. The patient was diagnosed with IHPTH. Calcitriol 0.5mcg BID and calcium carbonate 1000mg TID were initiated. CT brain without contrast was obtained which showed bilateral basal ganglia and right cerebellar hemisphere calcifications. When encountering hypocalcemia, clinicians should rule-out common causes of low serum calcium values, including hypoalbuminemia, CKD, prior neck surgery, vitamin D deficiency, magnesium deficiency, pseudohypoparathyroidism as well as hypoparathyroidism. In addition, queries about the complications of a low serum calcium level should be made. Once IHPTH is diagnosed, clinicians should look for basal ganglia calcifications to assess the duration of the condition. In addition, calcifications may be evident in the cerebellum, cortical white matter and the thalamus. Studies suggest that high serum calcium-phosphorus products deposit in soft tissues, although the exact mechanism by which this product is preferentially deposited into the basal ganglia is not understood. We present this case to highlight the association between basal ganglia calcifications and idiopathic hypoparathyroidism.

Oral Manifestations of Two Cases of Idiopathic Hypoparathyroidism

Oral Manifestations of Two Cases of Idiopathic Hypoparathyroidism

A Case of Idiopathic Hypoparathyroidism with Extensive Intracranial Calcification

Idiopathic hypoparathyroidism is frequently associated with intracranial calcification and neuropsychiatric abnormalities. The most commonly recognized central nervous system manifestations of chronic hypoparathyroidism are seizure, alteration of mental function and extrapyramidal signs. We present a case of hypoparathyroidism, demonstrating extensive intracranial calcification, not only basal ganglia, but also outside the extrapyramidal system. An 58-year-old woman presented with 30 year history of seizure and memory disturbance. The physical examination and several laboratory studies disclosed normal. However hypocalcemia, hyperphosphatemia with hypocalciuria and decreased parathormone level were demonstrated. Clinical symptoms and signs showed improvement after supplementary calcium and Vit therapy.

A Case of Idiopathic Hypoparathyroidism with Enamel Hypoplasia in Deciduous Teeth

A Case of Idiopathic Hypoparathyroidism with Enamel Hypoplasia in Deciduous Teeth

Magnetic resonance imaging of the brain in idiopathic hypoparathyroidism: A case report

The relationship between extensive bilateral intracerebral calcification and the various hypoparathyroidism states is well known on CT scans [ 11. Recently, MR images of the brain in postoperative hypoparathyroidism [ 21 or pseudohypoparathyroidism [ 3-51 have been documented and show abnormal intensities in the basal ganglia or dentate nucleus corresponding to calcification on CT. A case of idiopathic hypoparathyroidism with MR imaging is presented: to our knowledge, this is the first report on MR images of idiopathic hypoparathyroidism.

Diffuse skeletal hyperostosis in idiopathic hypoparathyroidism

A case of idiopathic hypoparathyroidism (IHP) is reported with extensive ligamentous and tendinous ossification and soft tissue calcification. The pertinent radiological features of IHP and the unusual findings in this case are reviewed together with similar previously reported cases. Whether IHP is a causative or aggravating factor in the aetiology of the skeletal changes is discussed with particular reference to their similarity to diffuse idiopathic skeletal hyperostosis (DISH). We conclude that, in patients with an ossifying diathesis, IHP acts as a stimulant resulting in exuberant skeletal hyperostosis that is indistinguishable from DISH.

Idiopathic hypoparathyroidism and autoimmunity.

Only a small number of cases of idiopathic hypoparathyroidism linked to the presence of specific antibodies have been described until now. Serum antiparathyroid antibodies have been frequently discovered in the absence of overt parathyroid disease. This suggests either that this kind of antibody is only a marker of genetic predisposition to immunological disease or more probably that subclinical hypoparathyroidism does exist though we lack the sensitive laboratory tests to prove it.

A Case of Idiopathic Hypoparathyroidism Treated with Various Vitamin D Metabolites Since the Newborn Period

A Case of Idiopathic Hypoparathyroidism Treated with Various Vitamin D Metabolites Since the Newborn Period

Idiopathic hypoparathyroidism with extrapyramidal and myopathic features.

A case of idiopathic hypoparathyroidism and basal ganglia calcification with extrapyramidal motor and myopathic features is described. The extrapyramidal motor and myopathic features disappeared when normocalcaemia was restored with treatment, suggesting that they resulted from hypocalcaemia.

Idiopathic hypoparathyroidism: A report of four cases

FOUR cases of idiopathic hypoparathyroidism are presented. In three of these cases there was evidence of familial endocrinopathy (cases 2, 3, and 4) and in two (cases 3 and 4) there was evidence of multiple autoimmune endocrine disease. The diagnosis of idiopathic hypoparathyroidism and some interesting features of the disease and its treatment are discussed.

A test on the recovery from hypercalcemia for evaluation of thyrocalcitonin activity in man.

In an attempt to develop a clinical test for thyrocalcitonin function, the recovery from hypercalcemia induced by an intravenous injection of 0.4ml per kg body weight of 8.5% calcium gluconate was evaluated through serum calcium determination before, immediately after, and 1, 2, and 3 hours after the injection. Approximate Expected Time of Recovery (AETR) averaging 5.4±0.4 hours (S. E.) in 25 normal subjects ranging in age from 17 to 72 years showed a significant positive correlation with age (P<0.05). AETR was not significantly different from normal in 10 cases of postoperative hypoparathyroidism, 6.5±0.8 hours, and 6 cases of hyperventilation tetany, 7.6±1.0 hours, while it was significantly shortened in 3 cases of idiopathic hypoparathyroidism and 4 cases of euthyroid goiter.

Idiopathic hypoparathyroidism presenting with seizures: A patient exhibiting mobilization of lead during treatment

A case of idiopathic hypoparathyroidism with a history of repeated grand mal seizures is reported. The patient exhibited papilledema and retinal hemorrhages despite normal cerebrospinal fluid pressure. The fundal findings, unilateral neurological signs and electroencephalographic abnormalities simulated a brain tumor, but cleared after treatment with dihydrotachysterol and calcium gluconate. Lead mobilization from skeletal stores occurred during therapy, and mechanisms involved in interrelationships between lead, calcium and phosphorus metabolism are discussed.

An unusual case of idiopathic hypoparathyroidism, adrenal insufficiency, hypothyroidism and metastatic calcification.

ABSTRACT A case of idiopathic hypoparathyroidism, adrenal insufficiency and hypothyroidism is presented. The patient, a female, was 3½ years old when the diagnosis of idiopathic hypoparathyroidism was first made. At the age of 5½ the first evidence of adrenal insufficiency developed, and the picture was complete one and a half years later. At this time hypothyroidism had developed, which proved to be primary in nature. This patient demonstrated roentgenographic calcification of the lungs, in the absence of abnormally high serum calcium levels or calcium-phosphorus concentration products, and without evidence of local tissue damage due to a chronic inflammatory process.

HOMOTRANSPLANTATION OF PARATHYROID GLAND IN IDIOPATHIC HYPOPARATHYROIDISM

A case of idiopathic hypoparathyroidism, in which homotransplantation appears to have been successful after a lag of 2 years, is reported. The donor was an infant and transplantation was done directly into a vascular area. Delay in function of the transplant may have been related to long continued administration of parathyroid extract.

IDIOPATHIC HYPOPARATHYROIDISM AND BILATERAL CONGENITAL GLAUCOMA IN THE NEONATAL PERIOD

A case of idiopathic hypoparathyroidism and congenital bilateral glaucoma in the neonatal period is reported. No previous reports of these two conditions occurring concomitantly have been found. No proven case of idiopathic hypoparathyroidism diagnosed during the neonatal period has been previously reported. It is postulated that the hypoparathyroidism and the glaucoma were both congenital in origin. Their relationship to each other is unknown.

IDIOPATHIC HYPOPARATHYROIDISM

IDIOPATHIC hypoparathyroidism is one of the rarer abnormalities of endocrine function in childhood. For that reason it may be missed on occasion because it is not considered among the diagnostic possibilities. There have been 6 cases of idiopathic hypoparathyroidism seen at the Harriet Lane during the past 10 years and the youngest child of this series was 17 months when admitted. This child's symptoms may have begun in the neonatal period and this may be true of other children with hypoparathyroidism. An apparently authenticated case of congenital hypoparathyroidism has been reported by Rhyne and also by Calcagno and Rubin. The etiology of this disease is completely obscure. There is ordinarily no story of multiple cases in families, except for a group of cases in which there has been a strange combination of moniliasis, hypoparathyroidism and in some instances adrenal insufficiency. The possibility that severe moniliasis may produce toxic injury to parathyroid and adrenal glands has been suggested, as has been the converse notion that the spread of monilia infections is facilitated by the biochemical disturbances of hypoparathyroidism. Among the 6 cases in our series only 1 has shown obvious moniliasis and this has not been of the extraordinarily severe degree reported in the literature. Some type of seizure either focal or generalized is the usual manifestation which brings the child to the physician. The seizures may persist for several years without becoming more severe and may be treated as epilepsy. One of the patients in this series was admitted at the age of 15 years.

Coexistent idiopathic hypoparathyroidism and pernicious anemia in a young girl: case report.

Excerpt Idiopathic hypoparathyroidism is a rare disease beginning more often in childhood or adolescence. In 1952 Steinberg and Waldron1reviewed 51 cases of idiopathic hypoparathyroidism and report...